title: Toronto orthopaedic boot camp III: examining the efficacy of student-regulated learning during an intensive, laboratory-based surgical skills course.
abstract: BACKGROUND
  Previous studies have presented compelling data that a 1-month "boot-camp"-style course can be a highly effective mechanism for teaching and developing targeted technical skills. In the current study, we examine whether performance of these targeted skills is improved when residents are trained using directed, student-led (SL) learning methods compared with traditional instructor-led (IL) learning methods.
  
  
  METHODS
  Twelve first-year orthopedic residents began their training with a 1-month, intensive skills course. Six residents were taught basic surgical skills using a format that focused on deliberate, SL exploration and practice of the skills under instructor supervision (SL group). The remaining residents were taught the same surgical skills using more traditional IL methods that included complete demonstration of the surgical task by an orthopedic surgeon, followed by an extended period of instruction (IL group). Performance on 4 targeted technical skills (sawing, bone drilling, suturing, and plaster splint application) was tested using an objective, structured assessment of technical skills examination for the 2 groups at the beginning and the end of the skills course.
  
  
  RESULTS
  Before the start of the skills course, there were no differences in performance scores between the 2 groups. On completion of the skills course, mean global rating scores for the 4 surgical skills tasks were greater for the SL group compared with the IL group: SL, 3.95 ± 0.1; IL, 3.42 ± 0.1; F(1,10) = 7.66 P < .02. A similar pattern of results was revealed by the checklists scores, with the SL group outperforming the IL group: SL, 94.9 ± 2.1; IL, 86.4 ± 2.1; F(1,10) = 8.512; P < .02.
  
  
  CONCLUSIONS
  Previous work has demonstrated the effectiveness of teaching basic surgical skills through an intensive course at the onset of residency. The present study shows that allowing surgical trainees to take a directed, student-regulated approach to learning basic surgical skills can further improve performance of these skills.
authors.affiliation: Department of Surgery, McMaster University, Hamilton; Ontario, Canada. ranil@skillslab.ca
authors.forename: Ranil R
authors.initials: RR
authors.lastname: Sonnadara
authors.forename: Shawn
authors.initials: S
authors.lastname: Garbedian
authors.forename: Oleg
authors.initials: O
authors.lastname: Safir
authors.forename: Carween
authors.initials: C
authors.lastname: Mui
authors.forename: Polina
authors.initials: P
authors.lastname: Mironova
authors.forename: Markku
authors.initials: M
authors.lastname: Nousiainen
authors.forename: Peter
authors.initials: P
authors.lastname: Ferguson
authors.forename: Benjamin
authors.initials: B
authors.lastname: Alman
authors.forename: William
authors.initials: W
authors.lastname: Kraemer
authors.forename: Richard
authors.initials: R
authors.lastname: Reznick
mesh_terms: D002983:Clinical Competence; D013502:General Surgery / Q000193:education*; D006801:Humans; D007396:Internship and Residency; D007753:Laboratories; D007858:Learning; D009985:Orthopedics / Q000193:education*; D013334:Students